Tag: RCM Referrals

There are claims that get paid and then there are those that are denied. What signals a claim to be passed over? Patient eligibility, correct coding, timely submission, etc. – all can determine if the claim will be paid. Practices often don’t realize the importance of referrals in getting the claim paid. If you miss a referral, the claim is most certain to be denied. Also, the more patients referred to you, the better your reimbursements.

Let’s look at some points/methods to keep a healthy relationship with your referrals and produce more of them:

Get to Know Them
Make a list of all the providers in your locality – existing and prospective ones. Ask for reports. Identify how many patients have been referred to you by existing referrals and focus your resources on starting a conversation with prospective referrals. Most of the modern practice management software will provide you with customized referral reports (if not, ask your billing partner to get it for you). Identify the top referrers. Many practices also ask new patients how they came to know about the practice – through marketing material or through referral from another patient or provider. Make a note of new referrals regularly.

Build a Rapport
After determining the top referrers, build a closer relationship with them. Simple thank you emails are a good starting point. Keep referrers in the loop with the ongoing treatment plan for a particular referred patient. This sense of importance not only helps the patients get a transparent healthcare delivery, but also identifies you as a responsible provider. Offer flyers/brochures of your top referrers in the practice for patients to take away. Keep referrers in sync with the current events happening in your practice such as new procedures that you have started, new insurances you participate with and so on. By involving your referrer, you are sharing, and, ultimately, building a trusting relationship that may broaden your scope of seeing more patients through referrals.

Treat Patients Well
It is a cliche. An independent survey, with regard to factors involving interaction between primary care physicians and specialists, three items were of major importance to most respondents: previous experience with the specialist (59%), quality of specialist communication to the primary care physician (53%), and the specialist’s efforts to return the patient to the primary care physician for primary care (51%). Most primary care physicians rate previous experience with the specialist to be the biggest factor in the referrals process. Physicians alone may not be the only source of referrals. Satisfied patients are also a significant source of referrals.

With health insurance plans dictating in-network providers, practices that look forward to build their referral base will need to get proactive. Those investing in relationships with referral sources and who make patient service a priority will win the repeat referral every time.